How to avoid tennis elbow
Tennis elbow is a generic term for a condition that might have any number of causes, any number of treatments, and any number of actual pathologies. For example, most people take it to imply ‘lateral epicondylitis’, which implies an inflammatory condition, but is more likely to be degenerative in nature (and could be called a tendinosis or tendinopathy).
Strangely enough, tennis elbow is actually more common in people who don’t play tennis than those who do. For the tennis population, it mainly occurs for those aged 40 to 50, but can affect any age group. It is also important to note that there are many conditions which can be masking as tennis elbow but could stem from the cervical or thoracic spine; or even be from the neural structures. Make sure that you seek the best diagnosis before continuing. For the purpose of this article, tennis elbow is defined as the degenerative condition of the extensor carpi radialis brevis (ECRB) tendon, where the pain is about 1 to 2cm below the elbow joint.
Prevention is better than cure
We are still not 100 per cent sure what causes tennis elbow, but we do know that there are some contributing factors. Below are three ideas that might help prevent the condition.
Take time to adapt to a change in your tennis routine
In simple terms, whenever you make a change to your tennis make sure you decrease your hitting volume and slowly advance it over a period of time. Remember, a change to your tennis routine is going to give your body a new stress and it will take time for it to adapt.
This applies to any and all changes you might make regarding your tennis life, such as: new racket, new string tension, new grip size, new court surface, new technique. This will go a long way to decreasing the likelihood of days, weeks or even months of debilitating pain. Other potential causes include hitting wet, or heavy, balls, hitting into the wind, or often hitting the ball late. Make sure you recognise the potential problematic situation and decrease your hitting volume accordingly.
Assess and adjust your technique
There seems to be a trend that players who do not use their legs or their body weight adequately are at a greater risk of developing tennis elbow. Both of these technical errors require much of the force to hit the ball to be developed by the arms. This is less efficient and places more stress on the elbows. Also, those who lead with their elbow on their backhand could be on a similar path. All of these technical issues can be improved through good coaching – so find the best coach you can for enough sessions to reduce the strain on your elbow.
Improving the strength of your forearm muscles will go a long way in preventing tennis elbow. A light, hand-held weight of about 200grams to 500grams would be an ideal starting point.
Holding the weight, sit on a chair, place forearm on your thigh, with your wrist and hand free to move up and down. Perform 20 repetitions of wrist extension and 20 repetitions of wrist flexion, both using a full range of motion. Build up to at least 3 sets before (gradually) increasing the weight.
Grant Jenkins is the Physical Performance Coach at the National Academy Queensland in Australia. He oversees the physical development and rehabilitation of all the NAQ athletes. He also manages the Sport Science aspect of the program. Follow him on twitter @Grant_Jenkins or email firstname.lastname@example.org.